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Opioids are all over the news these days, and with good reason. According to the Centers for Disease Control and Prevention, 91 people a day die from an opioid overdose—and almost half of those involve a prescription. Everyone agrees that we’re in the midst of a terrifying opioid epidemic.
Though highly addictive, opioids continue to be prescribed in record numbers. It’s no wonder people are starting to look for ways to decrease or stop taking opioids altogether. One promising alternative is marijuana. Cannabis has been shown to provide commensurate levels of pain relief as opioid drugs, but without the side effects or possibility of overdose.
Here are the top three questions from our Answers platform, asked by members of our community, about opioids and the possibility of using medical marijuana in its place. Our members—doctors, cannabis-business owners and experienced consumers—contributed some helpful suggestions to help people explore if medical cannabis could be a way to avoid opioids and all that comes with them.
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Q: I’m having open heart surgery soon and I want to reduce my use of opioids post surgery. Is the use of cannabis safe? If OK, is smoking or vaping OK?
A: @PerrySolomonMD I think that's an excellent idea. Studies have shown that cannabis use with opioids can decrease your opioid use up to 25%. However, there are several things to consider. After your surgery for several weeks your medications may be changed, added or discontinued by your cardiologist or surgeon. These changes can affect your blood pressure and heart rate, so both should be stable before starting cannabis since it can sometimes cause changes in both. During this time, you might need to take some narcotics that the surgeon has prescribed. Everyone's reaction to the chest wall pain after open heart surgery is different and you may find that your pain is minimal by the time your medications, blood pressure and heart rate are stabilized.
When all is stable I would suggest speaking with the surgeon and cardiologist to tell them that you would like to take cannabis for pain, if in fact it is still there, to decrease your use of narcotics. Cardiac surgery patients usually begin cardiac rehabilitation two to four weeks after uncomplicated cardiac surgery, but this depends on your physical condition prior to surgery and other factors such as any difficulties during or after surgery.
When cardiac rehab does begin you may experience chest wall pain from the deeper breathing that you get from the exercise program to strengthen the heart muscle than you get from rehabilitation. It is this chest wall discomfort or pain that you might need to use cannabis for if anti-inflammatories do not work (which sometimes is all that is needed at this point).
Now to finally answer your question. Since it’s usually the chest incision that causes the most discomfort after open heart surgery (verses minimally invasive cardiac surgery that can be performed if possible), I would avoid both smoking and vaping cannabis. The reason being, though both give the fastest effect, they both can cause irritation to your lungs if you’re not used to inhaling them, which can cause coughing. This of course can be painful with a fresh chest wall incision.
I would tend to use a tincture that can start to take effect within 15 to 30 minutes. A capsule is another option. I would tend to avoid edibles, except perhaps in the evening for sleep, only for the reason that the effect can take one to two hours and you would like pain relief faster than that.
Speaking of cardiac rehab, it has been shown to significantly decrease your chances of another cardiac event and I would highly recommendation beginning it as soon as possible after your surgery. If you need cannabis to help tolerate it instead of narcotics, then go for it!
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RELATED: CANNABIS: AN EXIT DRUG FOR THE OPIOID EPIDEMIC?
Q: My mom wants to get off of the opioid meds, but she doesn’t want to replace it with THC.
My mom had chronic pain due to nerve damage. She currently uses CBD and is working to stop using opioids. It’s not going as well as we hoped it would, but is there something she can use to get off the opioids and not replace it with THC?
A: @nurit Hello there, I hope this finds you well!
I'd like to state I'm not a doctor. I own a delivery service in Marin County and I'm proud to say I have helped dozens of people get off opiates and onto cannabis—I think that everyone's body is different and it will take some experimenting on how much/which strains/methods you use of cannabis but yes you will most likely be very successful switching/detoxing from opiates and onto cannabis.
I found these articles helpful!
https://www.leafly.com/news/science-tech/the-medical-minute-cannabis-and-opioids
http://www.beyondthc.com/hellomd-data-will-confirm-cannabis-as-substitute-for-opioids/
I hope this was helpful!
Q: Pain tolerance and CBD strength
I have been taking very strong painkillers/opioids for years and was wondering if that would/should impact the strength of CBD needed to relieve my pain.
A: @CannaBear My aunt that had been on opioids for years for cancer-related issues switched to cannabis and quickly realized how effective the cannabis treatment was for her. The body reacts differently to cannabis-derived products, so always start slow and work your way up to what works. All cannabis products have a learning curve that varies from every individual, so be patient in finding your dosage. My aunt did well with 2:1 CBD to THC tinctures.
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If you’re new to cannabis and want to learn more, take a look at our Cannabis 101 post. HelloMD can help you get your medical marijuana recommendation; it's easy, private and 100% online.
